Released in the UK as:Junk Medicine: Pharmacological Lies and the Addiction Bureaucracyby Theodore Dalrymple
Published August 27, 2007
Harriman House Publishing
ISBN-10: 1905641591
ISBN-13: 978-1905641598Official WebsiteView at Amazon

Reviews:

Dominic Lawson; “Addiction is a moral, not a medical, problem”; The Independent; February 6, 2007

Theodore Dalrymple has never been one to shy away from the truth, no matter how controversial, and he continues the trend in this book by exposing all the modern myths about opiate addiction. “Almost everything everyone knows about it is wrong,” he says, “and obviously wrong.” He cites medical science, literature and the common experience of doctors (all of which are in plain view but ignored) to back up his central contention that the vast majority of opiate addicts are not innocent victims but are responsible for their own addiction and that opiate addiction is not an irresistible physical craving but a moral failing, the result of a conscious decision that people make, mostly to alleviate their existential woes.

Addicts, he says, do not get addicted easily. They choose to take opiates knowing full well the dangers they pose. They must take them in great quantities for a year or more to become addicted, and even then, sufferers are not helpless. It is not true that addicts are compelled to commit crimes in order to feed their habits. Rather than addiction causing crime, the opposite is true: crime causes addiction. The vast majority of addicts are simply bad people that already live criminal and anti-social lifestyles before they first take heroin, and their existential problems (a lack of purpose in life; no incentive to work, since public welfare provides for them; no cultural interests; no moral foundation from religion or elsewhere) lead to boredom and a desire for escape via the oblivion of drugs. They enjoy the network of acquaintances, the routine and the drama of escaping detection by the police that opiates provide.

Contrary to popular opinion, withdrawal from opiates is not medically serious, much less life-threatening, as portrayed in popular media. At its very worst, it is like the flu and lasts only a few days. During the withdrawal period, addicts can become irritable, but the popular image of near-death experiences are pure fiction and in fact probably contribute psychologically to the discomfort of withdrawal. Patients often fake or exaggerate their symptoms to win sympathy or to convince doctors to prescribe methadone. In the end, addicts can break their habit if they make the decision to do so and go “cold turkey” for a few days. Dalrymple cites patients who broke their habit because their wives (or rather, the “mothers of their children”) demanded they do so, as a precondition for visiting their babies. If heroin addiction is a disease, it is one that is fundamentally different than cancer or AIDS, which cannot be cured by the providing of incentives.

Medical issues may arise out of addiction, but this does not make it a disease any more than sports injuries make football a disease. There is almost nothing that doctors or medical clinics can do to end opiate addiction, and yet a “treatment” bureaucracy has grown up that benefits from and perpetuates the myths in order to justify ever-larger government largesse. These doctors and auxiliary workers have become addicted to addiction, which has simply grown hand-in-hand with supposed attempts to alleviate it. This issue is clearly very personal for Dalrymple, who calls the book his “personal exorcism or catharsis” after years of toiling in an “atmosphere of Kafka” and struggling against the “prevailing and unassailable orthodoxy” of the medical establishment.

Dalrymple locates the source of these myths in literature, especially the “dishonest, exhibitionist and self-dramatizing claptrap of the early nineteenth-century Romantics” like Thomas De Quincey and Samuel Taylor Coleridge, both of whom were “opium eaters” who claimed addiction was a source of profundity. More recently, William Burroughs justified heroin and its related, depraved lifestyle as being more “real” and thus somehow desirable. The general public has been persuaded to accept the myths of addiction as a means to display their compassion and virtue.

As a solution, Dalrymple proposes closing all drug clinics, whose needle exchange and other “harm reduction” programs only serve to infantilize addicts. Methadone substitution programs should be ended, since they are not a cure (despite the flawed studies that purport to prove otherwise) and actually increase rather than decrease addiction. He is against legalization since it is likely to make drug abuse more widespread and not less.

In the end, opiate addiction is a function of ideas, and that is where the battle must be fought. Like so much in the modern world, the facts are available but ignored. Speaking the truth is considered “mean” and deserving of condemnation. Modern beliefs about opiate addiction are yet more evidence that conventional wisdom is not exactly the result of an objective search for truth.

6 thoughts on “Romancing Opiates & Junk Medicine”

Finally read an article about addiction particularly heroin is true. I live in San Francisco CA, where needle exchange, methodone clinics and free health services are prolific. My girlfriend of 12 yrs was not an oppiate addict until the last 5. For all of the first 10 we lived in differenct states so I did not see first hand what really was going on. I went to SF to get her 2.5 yrs. ago, and take her back to my home in Houston. We moved back to SF over a year ago for my job and also the natural beauty environment of CA.

The following paragraph written is so true:

“…The vast majority of addicts are simply bad people that already live criminal and anti-social lifestyles before they first take heroin, and their existential problems (a lack of purpose in life; no incentive to work, since public welfare provides for them; no cultural interests; no moral foundation from religion or elsewhere) lead to boredom and a desire for escape via the oblivion of drugs. They enjoy the network of acquaintances, the routine and the drama of escaping detection by the police that opiates provide…”

She was living an anti social lifestyle long before becoming an oppiate addict. A teenage defiant, disobiediant and totally against society and the norm. Raised in a addicts home, it is simple she will not deal with her mental and phsychological wounds and issues underlying her escape. Now that I am living with her I am exposed to her loser friends/addicts daily. They all are children who refuse to grow up, face the world and be a contributing member of society. They love the life on the street, the adreline rush, the drug dealing that goes with, they run in packs like wild animals feeding off each other. In and out of jail, liars, thieves and con artists and much worse for some. Some much much worse.

Mao’s solution was viscious and inhumane, but I agree close the clinics, close the needle exchange programs, stop giving food stamps, goverment financial assistence and lock those up for long periods of time for what they are un moral I don’t want to work I just want to play all day individuals who choose to check out and make excuses with their stories of why they are the way they are.

It is Bullshit and if your dealing with an addict time to treat it the way it is. An excuse to use and not grow up and deal with their problems just like anyone who is an adult does every day.

True scepticism requires an individual to be most sceptical of his or her own hard held views
So I challenge you,

Go 3 weeks on morphine or a equivalent Professor Dalrymple, 3 shots a day, sufficient to stop your tail flicking on the hotplate test when compared to the controls! (okay you know what I mean Professor)

and then lets get the video recorder on your face and body language after you get a fully antagonist (full receptor displacement dose) of naloxone or better still swallow a naltrexone pill 50 mg and wait an hour then start filming you. Why preferably naltrexone?

So we get to the truth! perhaps for a whole 24 hours of watching you shiver and flick your rat tail, so that junkies get a bit of justice and you learn to take full responsibility for your statements. Yes Mr Dalrymple, perhaps junkies are easy targets for cowards that care only about themselves?, and controversial psuedo-science claims may make books sell well, adter all high ranking medicos never do that, do they?, Such controversies are profitable indeed for only addicts of greed and power, and you are no addict to anything are you Professor Dalrymple?!. No substance or thought or belief?

I guess all the test lab rats now days are faking it too, probably many are UK bred rats? as I think I have seen them addicted (via precipitated withdrawal) within a week in some controlled trials on morphine etc. My God liberal left wing thinking has damaged those rats via their weakened moral resolve too! Mind you most in my department are neo-cons, Glaxo would not have them otherwise

And after all why not continue to exploit junkies a bit more now you have retired, they are hardly in a position to defend themselves from your high credibility SELF. and most are so shell shocked they will not notice another back stab, will they?. I can only pray you had a little more evidenced based wisdom, experiential honesty and compassion when you where employed treating them? or God help us all. even those of us mainly addicted to telling fibs,

Thank You SO much, Dr. Brown. I came across this website following a cross reference from Dr. Ben Goldacre’s ‘Bad Science’ website. I was actually replying to a man who’d posted a response to Goldacre’s Illuminating essay, now almost twenty years old. From the tone of the response, I knew that the man had no experience of addiction. It seemed that he’d read about the ‘facts’ he was commenting on and, frankly, preaching about.
I know that Heroin is an exceedingly addictive drug. That actually, nobody consciously chooses ‘moral failure’ followed by the hell of Heroin addiction. That, depending on the physical and mental condition of the individual, it was possible to be addicted to Heroin in three weeks. That Heroin withdrawal (HW) is not like a bad dose of ‘flu. If it was, there wouldn’t be any addicts.

I was drawn to this book, as my own experiences with opiates shed light on how unrealistic the romance and mythology surrounding opiates can be. But my God, this guy is way off the mark. I’m interested in truth, not half-baked quacks sharing their massaged facts and disinformation in an obvious effort to push their own misguided and antiquated political agenda.
There’s some truth here though, that’s the thing! For example, arguably withdrawals *are* overstated in popular culture. They do very much exist though, and are worse than the flu – and that’s just the physical.
But let’s cut through the shit, Dalrymnple isn’t talking about opiates at all. He’s talking about class. That’s it. A war on the underclass.
Is a wealthy, functional opiate user a bad, immoral person as well? Because they certainly exist!
No, give me a fucking break. This book isn’t what I thought it would be at all.